Via Jake Tapper:
In yet more disappointing news for Democrats pushing for health care reform, Douglas W. Elmendorf, director of the Congressional Budget Office, offered a skeptical view Friday of the cost savings that could result from preventive care — an area that President Obama and congressional Democrats repeatedly had emphasized as a way health care reform would be less expensive in the long term.
“Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall,” Elmendorf wrote. “That result may seem counterintuitive.
“For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending — for that individual,” Elmendorf wrote. “But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. … Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness.”
Elmendorf offered this assessment in a letter (you can read it HERE) to Rep. Nathan Deal, R-Ga. Rep. Frank Pallone, Jr., D-N.J., Henry A. Waxman, D-Calif., and Joe Barton, R-Texas, were cc’ed.
In their continuing struggles with CBO, Democrats from President Obama on down have expressed frustration that Elmendorf doesn’t give Democrats’ health care reform proposals sufficient credit for cost cutting through preventive care.
“One of the things that’s disappointing about CBO — and frustrating — is all the work … done on prevention” that the CBO doesn’t factor in, Sen. Chris Dodd, D-Conn., co-author of the Senate Health Education Labor and Pensions Committee legislation, recently griped.
“You don’t get the benefit in CBO of cost-savings with prevention programs,” Dodd said. They’ll tell you how much an anti-smoking program may cost. They don’t tell you the benefit occurs when a number of people stop smoking.”
During the health care town hall meeting, President Obama said, “the Congressional Budget Office, the CBO, which sort of polices what all various programs cost, they’re not willing to credit us with those savings. They say, ‘That may be nice, that may save a lot of money, but we can’t be certain.’ So we expect that not only are we going to pay for health care reform in a deficit-neutral way, but that’s it also going to achieve big savings across the system — including in the private sector where the Congressional Budget Office never gives us any credit — but if hospitals and doctors are starting to operate in a smarter way, that’s going to help you even if you’re not involved in a government system.”
Don’t forget, Pelosi’s attacked the CBO as well.
Wonder how long it will be before Elmendorf gets the Inspector General treatment?
Cross-posted to Right Wing News, where I am helping guestblog for John Hawkins on Sundays.